Hey Scott - Our interpretation of CAP requirements for IHC Controls is the same
as yours. Our Her2 control is a microarray with 3+ case and a piece of normal
skin to serve as our negative tissue control.
If you have normal breast tissue adjacent to your tumor control, that can also
serve as a negative tissue control, but your procedure has to state it as such.
Our control tissue are 5mm punches of solid tumor, so we just add a punch of
normal skin.
I hope this helps, but sometimes, it's just not worth the argument.
Terri L. Braud, HT(ASCP)
Anatomic Pathology Supervisor
Laboratory
Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
ph: 215-938-3689
fax: 215-938-3874
Care, Comfort, and Heal
Message: 2
Date: Tue, 21 Nov 2017 21:05:51 +0000
From: "Lindrud, Scott" <scott.lind...@rice.willmar.mn.us>
Subject: [Histonet] Negative IHC Control for Her2
Hi All,
We are having an internal debate regarding Her2 IHC control tissue in our lab.
We run a MTA (multi tissue array) consisting of 0+, 1+, 2+, and 3+ Her2
staining tissue taken from lumpectomy/resection cases. I'm in the process of
searching for more tissue to use in future control blocks and it can be
difficult to find tissue that is 0+ and 3+.
I've discussed this with our pathologist in charge of Histology and he says
that we don't need to run all 4 of the cores as controls. He says all we need
to run is a positive control and a negative control. He says the positive
control could be a 2+ or 3+ and the negative control could be either a 0+ OR a
1+.
I respectfully disagreed with him and said the negative control is not meant
for accessing staining interpretation but to verify the sensitivity and
specificity of the actual antibody-antigen reaction. I said a 1+ is still
staining the tissue where there is no staining in a 0+ reaction. The 1+ is not
a negative staining reaction, but a negative interpretation. The pathologist
says I'm wrong.
The CAP in its checklist says "It is also important to assess the specificity
of each antibody by a negative tissue control, which must show no staining of
tissues known to lack the antigen". To me, a 1+ Her2 staining reaction shows
that that tissue has antigen and should not be used as a negative control.
So, after saying all that, can/should 1+ Her2 breast tissue be used as a
negative tissue control? Seems pretty straight forward to me, but I'm just a
Cytotechnologist/Histotech.
Thanks for any input!
Scott
Scott A. Lindrud, MLS(ASCP)CM CTCM
Histopathology Technical Specialist/Cytotechnologist Rice Memorial Hospital
301 Becker Ave SW
Willmar, MN 56201
WP(320)231-4406
Fax(320)231-4861
scott.lind...@rice.willmar.mn.us
________________________________
"This e-mail transmission is for the sole use of the intended recipient(s) and
may contain confidential and privileged information. Any unauthorized review,
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Message: 3
Date: Wed, 22 Nov 2017 16:02:21 +0000 (UTC)
From: Rene J Buesa <rjbu...@yahoo.com>
To: "Lindrud, Scott" <scott.lind...@rice.willmar.mn.us>,
"histonet@lists.utsouthwestern.edu"
<histonet@lists.utsouthwestern.edu>
Subject: Re: [Histonet] Negative IHC Control for Her2
Message-ID: <800857894.1231622.1511366541...@mail.yahoo.com>
Content-Type: text/plain; charset=UTF-8
You are right but, your point is?Regardless, the pathologist is the responsible
for his/her diagnosis/interpretation and the liability is his/hers.Remember
that for us histotechs, our "client" is the pathologist (always remembering the
patient behind the whole process) and our essential duty is to provide the
pathologist what s/he needs to being able to make the best and more accurate
diagnosis.Follow his/her instructions and your life will be much simpler and
less stressful.Ren?
On Tuesday, November 21, 2017 4:21 PM, "Lindrud, Scott via Histonet"
<histonet@lists.utsouthwestern.edu> wrote:
Hi All,
We are having an internal debate regarding Her2 IHC control tissue in our lab.?
We run a MTA (multi tissue array) consisting of 0+, 1+, 2+, and 3+ Her2
staining tissue taken from lumpectomy/resection cases.? I'm in the process of
searching for more tissue to use in future control blocks and it can be
difficult to find tissue that is 0+ and 3+.
I've discussed this with our pathologist in charge of Histology and he says
that we don't need to run all 4 of the cores as controls.? He says all we need
to run is a positive control and a negative control.? He says the positive
control could be a 2+ or 3+ and the negative control could be either a 0+ OR a
1+.
I respectfully disagreed with him and said the negative control is not meant
for accessing staining interpretation but to verify the sensitivity and
specificity of the actual antibody-antigen reaction.? I said a 1+ is still
staining the tissue where there is no staining in a 0+ reaction.? The 1+ is not
a negative staining reaction, but a negative interpretation.? The pathologist
says I'm wrong.
The CAP in its checklist says "It is also important to assess the specificity
of each antibody by a negative tissue control, which must show no staining of
tissues known to lack the antigen".? ? To me, a 1+ Her2 staining reaction shows
that that tissue has antigen and should not be used as a negative control.
So, after saying all that, can/should? 1+ Her2 breast tissue be used as a
negative tissue control?? Seems pretty straight forward to me, but I'm just a
Cytotechnologist/Histotech.
Thanks for any input!
Scott
Scott A. Lindrud, MLS(ASCP)CM CTCM
Histopathology Technical Specialist/Cytotechnologist Rice Memorial Hospital
301 Becker Ave SW
Willmar, MN 56201
WP(320)231-4406
Fax(320)231-4861
scott.lind...@rice.willmar.mn.us
________________________________
"This e-mail transmission is for the sole use of the intended recipient(s) and
may contain confidential and privileged information. Any unauthorized review,
use, disclosure, or distribution violates confidentiality and privacy laws and
is prohibited. If you are not the intended recipient, please notify the sender
immediately and delete all copies of the message. Thank you."
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